Prolonged PPI Use Linked to Impaired Nutrient Absorption and Bone Health, Brazilian Study Warns
A study conducted by researchers from the Federal University of São Paulo (UNIFESP) and the ABC Medical School (FMABC) in Brazil indicates that the prolonged use of proton pump inhibitors (PPIs) may impair nutrient absorption and compromise bone health.
The research suggests potential risks for osteoporosis and anemia from continuous omeprazole use, alongside significant changes in immune system cells.
Key Findings on PPIs and Health
Published in the journal ACS Omega and supported by FAPESP, the research evaluated the effects of continuous omeprazole use on the absorption of essential minerals in rats. The study specifically investigated iron, calcium, zinc, magnesium, copper, and potassium.
Animals treated with omeprazole exhibited altered mineral distribution, including accumulation in the stomach and imbalances in the spleen and liver. Blood tests also revealed an increase in calcium and a decrease in iron, suggesting potential risks for osteoporosis and anemia. Furthermore, significant changes in immune system cells were detected.
Understanding the Research Methodology
Adult rats were divided into control and omeprazole-treated groups. Experiments lasted 10, 30, and 60 days to simulate varying durations of human drug use, providing insights into both short-term and prolonged exposure.
How Proton Pump Inhibitors (PPIs) Work
PPIs, including omeprazole, pantoprazole, and esomeprazole, inhibit the H+, K+, ATPase enzyme (proton pump), which is crucial for hydrochloric acid production in the stomach. While this effectively reduces gastric acidity to treat conditions like ulcers and reflux, it also hinders the absorption of many nutrients that require an acidic environment.
Warnings and Expert Recommendations
Researchers warn against the trivialized and prolonged use of PPIs, often without medical supervision, emphasizing that adverse effects should not be overlooked.
ANVISA's approval for over-the-counter sale of 20mg omeprazole without a prescription, effective November 2025, raises concerns about increased self-medication beyond the recommended 14-day treatment limit.
ANVISA stated that its OTC approval aims to rationalize use and promote safe, responsible consumption, reinforcing that the drug is intended for mild, temporary symptoms only. Crucially, ANVISA clarified that packages containing more than 14 days' worth of capsules cannot be sold without a prescription.
The study's findings extend to other modern PPI molecules like pantoprazole and esomeprazole, which share similar mechanisms and may have even more intense and prolonged effects. Researchers strongly emphasize the importance of rational drug use and medical supervision to assess individual cases and recommend supplementation if deficiencies arise.